Confession
I am not a big fan of water births.
No, I qualify that, I hate doing waterbirths with gloves on. I can deal with the blood and the vernix and the feces and the mucus - yep my fabulous job is full of these things, but I hate the facade of 'universal precautions' which we for some reason persist in attempting to perpetuate when we pull on sterile gloves which we then place in a tub to fill up with water and all the aforementioned bodily exudates.
A few months ago in the ACNM Journal of Women's Health there was a stunningly beautiful essay about blood. About how, over the course of a midwife's several decades of practice, she had been forced to become estranged from the glossy, beautiful, life giving (and ironically potentially life taking) fluid which midwives are so familiar with. It was written as something of a lament, and I identified with it. I have always loved blood, I love the idea of it, the color of it, the little adrenaline surge I get when I wait on a placenta for the 'gush' which heralds its decent and the much bigger rush I get when women bleed briskly, and then we work to stop it. The shocking heat of expressed clots running over the back of your hand. I even love the coppery smell of it. There is something fundamental and awesomely powerful about blood. I don't mind blood at all. And even the other stuff. It's part of the process. A sometimes messy process.
I understand the risks of HIV and the Hep's (B, C). I'm exceedingly fortunate to work with an exceptionally low risk population, most of whom are tested for everything except C. I am fully vaccinated (and my kids too) for Hep B. But I also know that theoretically, every time I put my hand in a birth tub I could be exposing myself to C and even with all the testing... well, who really knows what else. Occupational hazard I guess?
I know of many midwives who have women get out of their labor tub to have their babies and yet more who insist on women getting out to deliver their placenta (it can be trickier to gauge blood loss). I'm fine with women doing both these things - roughly 50% of women in the practices where I'm training birth both their babies and their placentas in the water. But I need to be on the record as really getting fed up with holding my hands up to allow the pink-red, vernix (and whatever else) flecked water to run out of my gloves. That makes me feel grosser than anything. Oddly, I'd feel less 'icked' with no gloves on at all.
And then there's the fact that my back hurts for days after a waterbirth.
It's not about me though, so if a woman wants to have her baby in the water, I'm ok with it. But I'm sure looking forward to saying to my clients "You want a water birth, I'm not going to bother with the gloves. You ok with that?".
No, I qualify that, I hate doing waterbirths with gloves on. I can deal with the blood and the vernix and the feces and the mucus - yep my fabulous job is full of these things, but I hate the facade of 'universal precautions' which we for some reason persist in attempting to perpetuate when we pull on sterile gloves which we then place in a tub to fill up with water and all the aforementioned bodily exudates.
A few months ago in the ACNM Journal of Women's Health there was a stunningly beautiful essay about blood. About how, over the course of a midwife's several decades of practice, she had been forced to become estranged from the glossy, beautiful, life giving (and ironically potentially life taking) fluid which midwives are so familiar with. It was written as something of a lament, and I identified with it. I have always loved blood, I love the idea of it, the color of it, the little adrenaline surge I get when I wait on a placenta for the 'gush' which heralds its decent and the much bigger rush I get when women bleed briskly, and then we work to stop it. The shocking heat of expressed clots running over the back of your hand. I even love the coppery smell of it. There is something fundamental and awesomely powerful about blood. I don't mind blood at all. And even the other stuff. It's part of the process. A sometimes messy process.
I understand the risks of HIV and the Hep's (B, C). I'm exceedingly fortunate to work with an exceptionally low risk population, most of whom are tested for everything except C. I am fully vaccinated (and my kids too) for Hep B. But I also know that theoretically, every time I put my hand in a birth tub I could be exposing myself to C and even with all the testing... well, who really knows what else. Occupational hazard I guess?
I know of many midwives who have women get out of their labor tub to have their babies and yet more who insist on women getting out to deliver their placenta (it can be trickier to gauge blood loss). I'm fine with women doing both these things - roughly 50% of women in the practices where I'm training birth both their babies and their placentas in the water. But I need to be on the record as really getting fed up with holding my hands up to allow the pink-red, vernix (and whatever else) flecked water to run out of my gloves. That makes me feel grosser than anything. Oddly, I'd feel less 'icked' with no gloves on at all.
And then there's the fact that my back hurts for days after a waterbirth.
It's not about me though, so if a woman wants to have her baby in the water, I'm ok with it. But I'm sure looking forward to saying to my clients "You want a water birth, I'm not going to bother with the gloves. You ok with that?".
posted by Louisa at 9:00 PM
15 Comments:
If there is icky stuff inside your gloves surely that makes them pointless. There is not that much reason to put your hands in the water anyway. Good luck with gloveless births. xxx
2 points-
one- the gloves still help to serve as a barrier to protect mom and baby from your germs.
two- they do sell shoulder length non sterile gloves,although i have never used them.
i have attended roughly 60 waterbirths, and i do prefer land birth. i truly believe birth is the way it is for a reason, and waterbirth seems so profoundly different than how we evolved giving birth.
but, i personally have never seen a complication due to waterbirth, and it sure can help with the pain.
Midwife, if my gloves are full of water, the woman has about as much protection from my germs as I do from hers. Really the only folks benefiting from this arrangement is the glove manufacturer! :)
I have heard tell of these shoulder length gloves. Perhaps I shall investigate.
If I had my hands in the water doing perineal "support" or catching a baby I would totally be sore. But you know, when you don't do those things you usually aren't sore the next couple days. And no worries about gloves.
As Barbara Harper says, "The solution to pollution is dilution". Consider, too, how various bacteria and viruses usually aren't hardy enough to last in birth water - and the simple act of dilution.
I love waterbirths because of the ability to watch the buoyancy of mothers ease their babies out without any assistance. ;)
xoxo
When I was a student, I worked with a midwife who loved to have mom's use castor oil and then waterbirth. After having my hands and arms in that stuff for a couple of years I learned a couple of things. 1)I really hate castor oil and waterbirths. 2)I pay a little more money for well fitting higher wrist surgical gloves. My hands come out of the water dry. My arms, chest, bra, etc. might be dripping though ;-).
we use elbow length gloves ordered from a vet supply catalogue - they are cheap and work wonderfully - no more dumping out water from the gloves! I love waterbirths now even more! www.taosbirth.blogspot.com
One more reason why I love you and wish I lived in Leafy Corner--your honesty.
I LOVE that you admit how much you hate waterbirth, but in the same breath recognize that it's not your choice.
Thank you for giving the power back to the Mama.
Well, I for one would be one of those clients. ;) I hate gloves, I would ultimately prefer a midwife NOT to wear them (unless of course she wanted to or was required to). So I know there must be other moms out there with my mindset too!
I am really glad that as much as waterbirth annoys you (and I don't mean that in a snarky way), you don't take on the approach of far too many CPs: "Well, this is difficult for ME to assist with, so I don't want YOU to do it." You're a wonderful midwife.
nak, but. . .
morag, even though water is getting in and outof our gloves (which can be mostly solved with tight surgical gloves), there is a big difference between having your hands in the same water as someone, as opposed to actually touching them, you know? especially if we are talking about fresh newborn skin or traumatized/swollen/lacerated vulvar tissue.
oops! I meant to say that we use SHOULDER length gloves - so we look silly with big purple arms - but they work fantastic wonderfully!
Have you ever considered that touch is important? Why would you want the first thing the baby feels in this world to be latex. Funnily enough latex allergies are on the rise.
lisa-
i think babies should be touched first by their parents. in most births I did very little touching of the baby at all. certainly not as much as the parents.
also, most midwives (and OBs, hospitals etc) use non-latex gloves nowadays. but i do see your point.
sJust had a waterbirth yesterday and my first shoulder dystocia. I was glad that the mom was able to stand up so quickly so I could get my hands up in there to pull her recalcitrant baby out, but I had my hand in her so far, it was deeper than my glove anyway. And I was thinking the same thing as I snapped open the wrist and watched the cloudy water run out. And all my muscles are sore today.
qI loooooved being able to birth my first baby in the water. It was so clearly the right choice for me and I think that my drug-free labor and delivery was aided tremendously by being able to float in the water. I didn't even think about how the gloves were working- or not- for my midwife. Hey-I was distracted;). She was able reach me and my baby just fine and I even think that she was able to remain fairly comfortable for the most part due to the fantastic birthing tub at my birth center. You can see it here;
http://www.iwp360.com/projects/holyoke/birthingcenter.html
Despite the fact that it looked like a gigantic potty, this thing was awesome! It was deep enough for me to be bouyant. It had all sorts of handy footholds and grips, including a bar overhead for me to grab onto if I wanted. It had several doors- very handy when I climbed out to deliver the placenta. One of the nurses snapped a picture of me just after I climbed in and I swear, I have never looked so comfortable.
As to the evoloution of birth, one could argue that one of the constant factors in birth throughout history is the mother. I'm sure I'm not the first mother who felt naturally drawn to water as an effective method of natural pain relief. The fancy tub was great, but the ocean has been around a loooong time too :)
I tend to leave mamas (and dads) alone when they are in the water. In fact, I am wont to say: If you're in the pool, I can't reach your perineum easily. Lucky for you!
I rarely wear gloves when women are birthing in the water, though I must admit it was quite odd doing a vaginal exam without gloves on a woman who was worried she felt a cord coming first. Interesting how our histories and experiences play into things.
An aside: It's an interesting consideration, being a lesbian midwife. This touching without gloves takes on a whole new meaning for some people. I don't think my own clients would be concerned, but surely some would. It's something I think about.
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